Healthcare Provider Details

I. General information

NPI: 1265511315
Provider Name (Legal Business Name): LESLEY P ABBOTT D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 02/09/2023
Certification Date: 02/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 ARGILLITE RD
FLATWOODS KY
41139-2615
US

IV. Provider business mailing address

524 SUNSET DROVE
ASHLAND KY
41101-2681
US

V. Phone/Fax

Practice location:
  • Phone: 606-833-1111
  • Fax:
Mailing address:
  • Phone: 606-232-9179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02808
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberKY020803
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: